I read this publication with interest, but caution that the conclusions may not be robust due to methodological flaws which are common across many radical prostatectomy (RP) papers investigating the utility of PSAD, most of which fail to include an internal reference for correlation of the prostate volume estimate. Highlighting this flaw, may serve as a template for future PSAD studies that involve RP specimens.

Ovarian epithelial type tumors of the testis have been a rare entity in clinic. Its' awareness and management remain a clinical challenge. We described a case of an 18-year-old, obese, boy who presented with scrotal enlargement. He underwent eversion of tunica vaginalis and resection of epidydimal mass. The histology of the resected sample showed ovarian epithelial type borderline tumor. We believe this case helps to strengthen awareness and management of this rare disease.

The ureteral stent is engrained in the fabric of urologic practice. Virginia Mason Medical Center had a unique role in its development through the pioneering work of Dr. Robert Gibbons. Here, we review his contribution to the evolution of the modern ureteral stent.

Prostate biopsy is one of the most common procedures performed by urologists with an estimated >2 million performed in the United States and Europe every year,1,2 and is the gold standard for the diagnosis of prostate cancer. The majority of prostate biopsies in the United States are done in the office setting using the ultrasound probe through a transrectal approach. The proximity of the posterior prostate to the anterior rectal wall provides easy access the peripheral zone which is known to harbor >70% of malignancies.

To compare outcomes with early versus delayed reconstruction following pelvic fracture urethral injury (PFUI) to determine if a traditional 3-month delay is necessary. This delay has been advocated to allow resolution of traumatic inflammation and hematoma but has never been validated. We proceed to reconstruction at 3-6 weeks if the associated injuries are stable, the perineum is soft on rectal palpation, and the fracture is stable for lithotomy positioning.

Pheochromocytoma and paraganglioma (PPGLs) are rare autosomal dominant disorders derived from the neural crest chromaffin tissuesof the autonomic nervous system. The succinate dehydrogenase complex subunit D (SDHD) gene has been implicated as one of the pathogenic genes. Although more than 100 SDHD mutations have been reported, the phenotype-genotype association remains unclear. Here we reported a case of a patient who presented with multifocal PPGLs and with a rare SDHD mutation. It is the first report linking this variant to multifocal PPGLs.

Inverted papilloma of the prostatic urethra is an especially rare finding. A 75-year-old man with urinary retention wished to proceed with a holmium laser enucleation of the prostate (HoLEP) and was found to have a mass arising from his prostate vs bladder on preoperative imaging. Cystourethroscopy revealed the mass arising from the median lobe of the prostate. After transurethral resection and frozen analysis confirmed the benign pathology of an inverted papilloma, the patient subsequently underwent a successful HoLEP during the same surgical setting.

Until recently, spina bifida has been regarded a pediatric health issue, and adult consequences of the disorder have not been explored. The congenital neurologic and urologic anomalies, as well as sequelae of bladder management, can have a profound impact on adult male sexual function. Abnormalities in testicular descent, testicular development and function, fertility, penile sensation, erectile function, ejaculatory function, and orgasmic function are common in this population. These adults have substantial gaps in knowledge in normal sexual function and potential dysfunction as it relates to them specifically.

A 49-year-old man presented to the urology clinic with one-year history of abdominal swelling and lower urinary tract symptoms, including incomplete bladder emptying, urinary urgency and frequency. Additionally, he complained of thin, loose stools for the past few months but had never had a colonoscopy or other work up. Immediately on physical exam, a palpable supra-pubic mass and a small umbilical hernia were noted with no obvious umbilical abnormalities or drainage.

To compare complication rates, perioperative outcomes, and survival after radical cystectomy (RC) in patients with prior abdominal and/or pelvic radiation therapy (RT) versus those without an RT history.

Pheochromocytoma is a rare chromaffin cell tumor that is may be associated with a genetic predisposition, such as Von Hippel-Lindau (VHL) disease. VHL is an autosomal dominant disorder that is characterized by a predisposition to multiple tumors including retinal and central nervous system hemangioblastomas, renal cell carcinoma and pheochromocytomas. The classic presentation of pheochromocytoma is episodic hypertension, headaches, palpitations, and diaphoresis. In the pediatric population, 40% of pheochromocytomas have a hereditary basis.

Imaging is critically important for the diagnosis, staging, and management of men with high-risk prostate cancer. Conventional imaging modalities, including computed tomography and radionuclide bone scan have been employed for local and metastatic staging, but their performance has generally been poor. Sodium fluoride positron emission tomography is recommended when there is high suspicion for bone metastases despite a negative or indeterminate bone scan. Magnetic resonance imaging has advantages in local staging but its value depends on the extent of disease.